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NPI Code Detail

MEDICARE: DR. KEVIN M. RATHKE M.D.

MEDICARE: DR. KEVIN M. RATHKE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084N0400XNeurology PhysicianME176911FL
22084N0402XNeurology with Special Qualifications in Child Neurology Physician01621NC
32084N0400XNeurology Physician2002-01621NC
42084N0400XNeurology PhysicianW2772TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1750313110
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KEVIN M. RATHKE M.D.
Provider Business Mailing Address
First Line : 1540 SUNDAY DR
Second Line :
City : RALEIGH
State : NC
Zip : 27607-6010
Country : US
Telephone Number : 919-782-3456
Fax Number : 919-787-7552
Provider Business Practice Location Address
First Line : 4709 CREEKSTONE DR
Second Line :
City : DURHAM
State : NC
Zip : 27703-9822
Country : US
Telephone Number : 919-385-8880
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2006
Last Update Date : 01/06/2026

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